Tag: balance bill

No Surprises Act: Exploring the Impact on Employees, Employers and Costs

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On March 7, CHIR hosted the second event in a series of policy briefings on the future of employer-sponsored health insurance, sponsored by Arnold Ventures. This event, featuring remarks from Congressman “Bobby” Scott and a panel discussion moderated by Julie Appleby of KFF Health News, focused on the No Surprises Act’s impact on consumers and implementation challenges associated with the independent dispute resolution process.

As Ground Ambulance Committee Begins Its Work, New Report on Balance Billing by Ground Ambulance Providers Highlights a Gap in the No Surprises Act

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On December 9, the Centers for Medicare and Medicaid Services announced the membership of the Advisory Committee on Ground Ambulance and Patient Billing, as required by the No Surprises Act (NSA). As the committee prepares to begin its work, there is new evidence out of Texas that the NSA’s exclusion of ground ambulance bills puts consumers at a significant financial risk when they need emergency medical transport.

Navigator Guide FAQs of the Week: Answers to Post-Enrollment Questions

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As of January 15th, the open enrollment period has ended in most states. A record number of consumers signed up for 2022 marketplace coverage. So what comes next for marketplace enrollees? First, give yourself a pat on the back for enrolling in health coverage! Second, consult CHIR’s Navigator Resource Guide for expert answers to FAQs about post-enrollment issues you may face, like unexpected coverage denials and balance bills.

Filling a Gap in the No Surprises Act: What are States Doing to Protect Consumers from Out-of-Network Ground Ambulance Bills?

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In January, the No Surprises Act will provide landmark protections against surprise billing, but ground ambulance services are excluded from the new safeguards. In a post for the Commonwealth Fund’s To the Point blog, CHIR experts discuss challenges related to ground ambulance reimbursement and state strategies for protecting consumers from surprise bills.

The No Surprises Act Interim Final Rule on Dispute Resolution, Uninsured Protections, and External Review: Implications for States

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Last month, the Biden administration published a third rule implementing the No Surprises Act, the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. The interim final rule (IFR) provides details on the independent dispute resolution process, protections for uninsured patients, and more. In a new Expert Perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies program, CHIR experts provide a summary of the IFR, identifying implications and considerations for states.

January Research Round Up: What We’re Reading

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To kick off 2020, CHIR’s Olivia Hoppe reviews studies on out-of-network billing from hospital-based physicians, the Affordable Care Act’s effect on racial and ethnic access disparities, health care market consolidation, and 2020 marketplace premiums and insurer participation.

The Texas Two-Step: Implementation of State Balance Billing Law Reveals Gaps in Consumer Protections

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In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas.

June Research Round Up: What We’re Reading

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This June, CHIR’s Olivia Hoppe caught up on policy studies and proposals on surprise medical bills, the affordability of coverage on the Affordable Care Act marketplaces, and state-level health system performance.

Balance Billing for Air Ambulance Remains a Problem in Maryland

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Although Maryland is among the handful of states that regulate balance billing for out-of-network situations, as we discuss in a previous report, the state’s law does not address air ambulance charges. Balance billing for air ambulances remain a problem in Maryland and its insurance department held a public meeting last Friday to discuss the issue. CHIR’s Sandy Ahn provides highlights of the meeting and other state efforts to address this consumer problem.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.